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statistics for nursing a practical approach
Fundamentals Of Pharmacology : An Applied Approach For Nursing And Health 2nd Edition Shane Hunt - Solutions
In what forms of constipation are laxatives contraindicated?
Which laxatives can affect the absorption of some vitamins, and why?
Sorbitol is a poorly absorbed sugar alcohol sometimes used to sweeten diabetic jams and jellies.What would be a problem with eating too much of this sugar alcohol?
Describe how to obtain a complete bowel washout to enable an unobstructed view during colonoscopy.
Apart from the use of laxatives, what are some of the measures that can be used to help prevent constipation?
Jack Brown, a 56-year-old patient, has been prescribed a peptic ulcer treatment regimen consisting of omeprazole, metronidazole and amoxicillin. How would you advise Mr Brown on ways to prevent problems arising from altered taste, diarrhoea and nausea?
Rose Goldstein, a 40-year-old patient, is ordered bismuth chelate for gastritis. What patient education would you provide?
What non-pharmacological measures can you advise for alleviating manifestations of a peptic ulcer?
Explain how ranitidine is advantageous over cimetidine as an H2-receptor antagonist.
Why should an antacid mixture and ranitidine not be taken at the same time?
Why is bismuth chelate therapy useful in the treatment of some types of gastritis?
What is Zollinger–Ellison syndrome, and why are H2-receptor antagonists and proton pump inhibitors useful in its treatment?
What problems could arise from antacids containing sodium bicarbonate?
What problems could arise from antacids containing calcium carbonate?
Why are magnesium and aluminium hydroxide often combined in antacid preparations?
Why have gastrectomies and vagotomies been more or less relegated to the past as surgical procedures for peptic ulcers?
Antacids are relatively cheap and have been shown to heal peptic ulcers, but they are rarely used as the sole treatment for such ulcers. Why?
Why would diphenhydramine, an H1 antihistamine, be useless in the treatment of a peptic ulcer?
What are the roles of prostaglandins in the production of gastric secretions?
What is the role of histamine in the production of gastric secretions?
Discuss the use of triple therapy in the treatment of some peptic ulcers.
Explain why proton pump inhibitors are the most effective drugs to use in hyperacidity problems.
Discuss the aetiology of peptic ulcers.
What precautions would you advise for a patient who takes a cough formulation containing pholcodine?
Dolly Agneau, 25 years old, wishes to take an antihistamine for an allergic respiratory condition.What advice would you give her regarding these drugs?
Marcus Larkin is a 38-year-old being treated for major depression. He is currently receiving treatment with the tricyclic antidepressant clomipramine. At the moment, Marcus is suffering with hayfever and usually takes an over-the-counter preparation containing pseudoephedrine for relief of his
Jason Totter, a 3-year-old toddler, is very distressed by a head cold. On browsing through the shelves in the local pharmacy, his mother comes across a cough and cold preparation containing aspirin. Would you advise her to buy this preparation? Why?
What patient education would you offer Molly Jones, who is keen to use a nasal decongestant spray for a blocked nose? Give rationales for your answer.
What are some non-pharmacological measures available to a patient to liquefy and loosen bronchial secretions?
Katrina Wenczel has a history of hypertension. What problems may occur following the use of a nasal decongestant?
Can you think of any disadvantages of these combination over-the-counter preparations for colds, influenza and allergy?
What is the rationale for combining a variety of drugs in one over-the-counter preparation?
What is the difference between an expectorant and a mucolytic agent?
State the mechanisms of action and common adverse effects of the following drug groups:(a) antiseptics;(b) mucolytic agents;(c) narcotic cough suppressants;(d) the expectorant potassium iodide;(e) nasal decongestants.
Outline the underlying pathophysiology of upper respiratory tract illness.
Jacqui Renney, aged 30 years, has managed her asthma with a salbutamol inhaler since being diagnosed as a child.After evaluating the effectiveness of her treatment, you determine that she uses her inhaler almost every day. She is woken at night by coughing and tightness in the chest. What would you
When taking a patient’s asthma history, what questions should the nurse ask?
What observations would you make to evaluate the effectiveness of bronchodilator therapy?
Yvonne Chow, aged 25 years, uses salbutamol and beclomethasone inhalers in conjunction with each other for asthma. Which inhaler should be used first? Why?
Natasha Beck, 3 years old, has been admitted to the emergency department with a moderately severe asthma attack.How does the management of her attack differ from that of an adult admitted with a similar attack?
Benjamin Habib, a 10-year-old patient, is newly diagnosed with asthma. What patient education would you provide him with regarding the use of an inhaler? (See Table 7.17 in Chapter 7 for assistance.)
Jason Stolten, a 15-year-old patient with asthma, is using a beclomethasone inhaler. He develops an oral thrush infection, which causes him great discomfort. What comfort measures can you recommend for Jason? What should Jason do to prevent a further oral infection? (See Table 11.7 in Chapter 11
Compare and contrast the mechanisms of action of the following asthma prophylactics: ketotifen, nedocromil, sodium cromoglycate and the leukotriene receptor antagonists.
State the problems associated with oxygen therapy.
Compare and contrast the mechanisms of action of the various bronchodilator groups.
Describe the pathophysiology underlying the extrinsic form of asthma.
State the three pathophysiological alterations associated with obstructive airways disease.
Explain why a patient receiving phenytoin antiseizure therapy may need to take a folic acid supplement.
Oral iron formulations should not be administered with tetracycline antibiotics. Explain the mechanism underlying this interaction. (See Chapter 15 for assistance.)
Nicole Jansen, 22 years of age, is 5 weeks pregnant with her first child. She is concerned about becoming anaemic during pregnancy but does not want to take iron supplements unless she has to.What advice can you give her about non-pharmacological means of managing this situation?
How would you evaluate the effectiveness of iron therapy for iron deficiency anaemia?
Intramuscular iron injections are administered by the Z-track technique to avoid leakage of iron into the subcutaneous tissue and skin. Leakage can lead to irritation and staining. Describe how to perform an intramuscular injection using the Z-track technique.
Svetlana Lutkina, an 85-year-old patient, takes ferrous sulphate for iron deficiency anaemia. She complains to you about nausea and abdominal discomfort. What comfort measures would you recommend? (See Table 11.10 in Chapter 11 for assistance.)
Anabolic steroid treatment of this condition has been largely superseded by therapy with which other drug?
Explain the role of anabolic steroids in the treatment of aplastic anaemias. Which organ’s function must be monitored closely during this therapy?
Identify which of the following agents is/are not usually administered orally:(a) folic acid;(b) iron dextran;(c) hydroxocobalamin;(d) folinic acid;(e) ferrous sulphate.
Identify a hypochromic microcytic anaemia and its treatment.
Identify a megaloblastic anaemia and its treatment.
Your patient, Barbara Loewenstein, is ordered 30 mmol potassium chloride intravenously. How would you administer this dose? Explain your reasoning. What observations would you make of Ms Loewenstein to determine whether she is hypokalaemic or hyperkalaemic?
Why is it important to melt fresh frozen plasma (FFP) gradually when preparing it for administration?
Molly Rattlers, a 70-year-old patient with dehydration, is ordered 1000 ml GelofusineTM at 100 ml/hour intravenously. What observations would you make to evaluate the effectiveness of the infusion?
With reference to what happens in the body compartments, explain why a colloid solution is preferable for a patient with a severe fluid volume deficit.
Explain the difference between colloid and crystalloid fluids.
What evaluation would you make of a patient to determine the effectiveness of an antidysrhythmic agent?
Maria Toraldo, a 65-year-old patient, is receiving nifedipine for the prophylactic treatment of angina. What patient education would you offer Ms Toraldo?
Voula Vousopoulos, a 75-year-old patient with congestive cardiac failure, is discharged from hospital with the following medication regimen: the angiotensin-converting enzyme (ACE) inhibitor enalapril, the loop diuretic furosemide and potassium chloride. What education would you offer Ms
What evaluation would you make of a patient to determine the effectiveness of the angiotensinconverting enzyme (ACE) inhibitor captopril in treating your patient’s congestive cardiac failure?
To which antidysrhythmic class do each of the following drugs/drug groups belong?(a) calcium channel antagonists;(b) beta-blockers;(c) digitalis.
Account for the facial flushing, headache and reflex tachycardia that may be observed after the administration of an organic nitrate such as isosorbide dinitrate.
With which electrolyte imbalance can the cardiac glycoside digoxin have a therapeutic blood level and still exert toxicity? Why?
Describe the following agents in terms of their chronotropic and inotropic effects (hint: for each term, the drugs may have a positive effect, a negative effect or no effect):(a) beta-blockers;(b) cardiac glycosides;(c) the dopamine agonist dobutamine;(d) non-selective β agonists.
Define the following terms:(a) automaticity;(b) chronotropic effects.
For each of the following drug groups, indicate which cardiac condition(s) they may be used to treat:(a) calcium channel antagonists;(b) cardiac glycosides;(c) beta-blockers.
Gaye Edging, a 50-year-old patient, is newly diagnosed with hypertension. She also suffers from insulin-dependent diabetes. What form of diuretic is suitable for treatment of her hypertension?
Kim Dong-Jin, a 55-year-old patient, is ordered spironolactone as part of her antihypertensive regimen. What patient education would you offer her?
Reece Place, a 65-year-old patient diagnosed with renal calculi, is ordered acetazolamide. Explain how acetazolamide affects this condition.
Anna Graaf, a 50-year-old patient, is receiving furosemide as part of her antihypertensive programme.What type of diuretic is furosemide? Explain the type of electrolyte imbalance that can occur with this diuretic.
A 64-year-old patient is receiving hydrochlorothiazide for congestive cardiac failure. What type of diuretic is hydrochlorothiazide? Explain the type of electrolyte imbalance that can occur with this diuretic.
Try to explain the mechanism of action of acetazolamide in the treatment of altitude sickness.
Why is antidiuretic hormone (ADH) sometimes called vasopressin?
Distinguish between the potency of the various diuretics.
Why is acetazolamide useful in the treatment of some forms of glaucoma?
Why do amphetamine addicts often mix the amphetamine with sodium bicarbonate?
Why would alkalinisation of the urine help in aspirin poisoning?
What are the dangers associated with hyper- and hypokalaemia?
Why would mannitol be ineffective as a diuretic if given by mouth? What might be the consequences of oral mannitol?
Why should diuretics not normally be administered at night?
Why might a diabetic patient become hyperglycaemic when on thiazides?
Why are potassium supplements often given during diuretic therapy? What alternatives are available to potassium therapy?
List the main causes of oedema.
Marian Evian, a 56-year-old patient receiving a heparin infusion, has an activated partial thromboplastin time (APTT) of 120 seconds. As her nurse, what would you do?
Explain the problems associated with an intramuscular injection of heparin.
Leonora Alexandro, a 50-year-old patient, is discharged home with warfarin. What patient education would you provide before discharge?
As well as the international normalised ratio (INR), what forms of assessment will be conducted on a patient commenced on warfarin in hospital?
Lienhard Krug, a 45-year-old executive, is brought into the emergency department following an acute myocardial infarction. It is determined that Mr Krug has a past history of peptic ulcer treated with ranitidine. Mr Krug is given streptokinase intravenously. What is a major issue relating to the
Why should a patient on warfarin be told not to eat too much cabbage?
Salicylic acid can be substituted for aspirin as an analgesic but not as an antiplatelet drug. Why?
Explain the mechanism of action of the plasminogen activators.
State the advantages of recombinant plasminogen activators over streptokinase.
Why is anaphylaxis a danger in the use of streptokinase?
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